They’re gone. Door ajar. The scene is plain as a college dorm room—two single beds, two desks, two chairs. Overhead light. Its austerity suits me. I’m in the hospital because I burn my skin and the behavior isn’t socially acceptable. In the most objective sense, the line between landing here and remaining on the outside falls on the differences between public and private, shame and pride, voluntary and involuntary.
Men and women the world over scar themselves as a means of linking identities and common values—loyalty, war-worthiness, prowess, aesthetic pride, or honor. The scars of prisoners and bushmen make group identity visible and permanent. The tracks down a junkie’s arm mark a broken tribe while serving as identification; when she’s buying junk they’re the best proof of not being a narc. My burns do the opposite—the secret of them separates me from anyone who doesn’t know they exist, much less what caused them. They are private—Dr. Kohl was the only one who knew about them until, of course, I blew it up and landed myself here.
Some people assume wrongly that burning or cutting is tantamount to trying to kill oneself. Not so. Shrinks have a term and even an acronym for what I do: non-suicidal self-injury (NSSI). That’s because even professionals confuse self-destructive behavior with a gesture toward death. Actually, what I do staves off suicide. Without it, I might not be able to say I’ve never tried to kill myself; without it, I’m not entirely certain I’d be able to make that claim. That’s part of the reason I love my scars. They track my successful feats of self-preservation. The power I feel when I burn myself trumps fear, turning suffering on its head by making it a pleasure in its own right.
It’s time for induction. I’m to tour the hall—a walk through the T-shaped unit with its wreck of tattered furniture cluttering the common room; TV room, where patients sit silently staring as light twinkles behind the screen of the talking box; men’s and women’s bathrooms; two shower rooms; two quiet rooms. The view through the open doors lining the hall to the left and right of the central common area reveals more bedrooms, duplicates of mine, plus one large dorm room with four bunks making eight beds. All rooms have enormous windows framing the ample span of cut grass and 100-year-old trees.
There are no curtains anywhere to block the light—or to hang yourself with.
A pay phone mounted on the wall directly across from the nurses’ station awaits a purpose. The enclosed professional space hums, a cozy nest filled with voices, laughter, the jingle of the hospital phone—a warmth passes through the glass of the medication window and spills into the hall, where it brings life to everything within reach. The shelf and sliding door of the med window resemble the convenience-store cashier windows I’ve shoved dirty bills through, grateful for the late-night dispensation of Zingers, Bud, and Camel Lights.
Chubby mouse appears before me only to launch into a rehearsed explication of B-1’s rules, her disproportionately small mouth painfully articulating words, their precision gummed by the most excruciating pauses. Rather than listening I imagine her words pouring out too fast to hear, flowing down her white uniform, a hot stream of silver liquid falling over the ledge of her giant breasts.
Since I don’t want to listen, I ponder requesting a copy of the rules so I can read them. How quickly I could decide which ones to follow and which to skirt, avoid, ignore, disregard, or otherwise disobey. Deciding against interrupting, I listen in spite of myself while looking around, up at the spots on the faraway off-white ceiling, down at the gray laces winding through the chipped white paint on the metal eyes of my pink high-tops.
1. No entering another patient’s room for any reason.
2. No physical contact between patients.
3. Medication distribution: 8:00 A.M., 12:00 P.M., and 5:00 P.M.
4. Showers by permission only.
5. Report patients dangerous to themselves, staff, or other patients.
6. No leaving the unit other than for a meal, therapy, or a scheduled activity.
7. Phone calls may be placed or received 5:00 P.M. to 9:00 P.M. with written permission from the patient’s therapist for general or specific “phone privileges.” Time limit for all phone calls: twenty minutes; ten if anyone is waiting.
8. Smoking permitted during designated smoking times three times daily between the hours of 9:00 A.M.–9:10 A.M.; 1:50 P.M.–2:00 P.M.; 7:30 P.M.–7:40 P.M.
CHAPTER 22
Well Documented
Being on Suicide Observation (SO) secures my status among the patients. Nobody gets too near a new SO. Even on a psych ward suicide is distasteful. I suspect there are few people here who haven’t considered it or actually tried it—usually more than once. Why obviously flirt with darkness?
The inaccessible outdoor foliage of the hardwoods, rolling lawns, and rowdy gangs of squirrels are framed by sturdy shatterproof glass. I can only look at it. To release a little tension from my brain I write one of my shitty poems I call “fragments” in a notebook. I study the sounds while I wonder at the lack of motion. There’s nothing for me to do, nowhere to go. I’m simply locked up. I don’t touch the food on the dinner tray that’s delivered to my room. Instead I lie on my bed facing the window until exhaustion takes over. I sleep.
It’s Friday, day two, heading into what I will learn is the deadly quiet weekend. As I discover, there’s no schedule for me. I must first see The Doctor. I haven’t been assigned my therapist, group therapy, or therapeutic activities. The program has not been unveiled—my very own personally designed schedule for wellness.
Until then and until my SO lifts, I’m not allowed off B-1, nor am I permitted to close the door to my room. I am allowed to use the bathroom even though there have been incidents of girls drowning by sticking their heads in the toilet and even one who creatively filled a trash can with water for the same purpose. The nurses get a visual of me on schedule, usually in my room, every twenty minutes. At night the nurse shines her flashlight right on me to be sure I’m there—breathing. Check.
The weekend’s stagnant doctor-free hall expires as Monday saunters in late. They’re back, the army of professionals here to mix up the monotony and make me right. Dr. William Simons, head physician, is off on his rounds, more than on time. He’s looking trim, his cheeks and chin and lip freshly shaved, pink on white, smelling of expensive soap, ready to chat. I’m not dressed and not noticeably alert, my bed little more than rumpled laundry beneath me. I’m not talking to this man.
As I quickly learn, decisive male voices signal rounds each weekday morning as the senior supervising doctors work their way through the ward, stopping to chat up the patients on the hall, perfunctorily knocking on the door to each room, never waiting for an answer before entering. The doctors speak in normal voices (not the hushed tones the nurses use), appearing larger as a result. Dr. Simons’s five minutes with me feel perfunctory: “How are you feeling today, Ms. LeFavour? Sleeping? Good. Good. Settling in?”
The nurses are another matter. Female to the last, they behave cautiously, unsure of me and what I’m capable of. It’s tempting to surprise them but then … they’re likely difficult to surprise, requiring gore and drama beyond my present abilities. So I remain a blank, dangerous as any void for its unknown quantity. Perhaps I’m not sure what I’m capable of either. I have no immediate plan to take to the razors, cigarettes, or matches, but I do like having them there. As the doctors who ordered the SO know, inpatient bulimics have close to a 40 percent rate of attempting suicide. Adding self-harm and depression to the mix results in an even more sobering percentage. I probably deserve my SO status, if only out of respect for the statistics.
Becoming an indoor cat at a psychiatric hospital in 1991 requires meeting a certain criterion—the objectively irrational self-mutilation I enjoy qualifies me under the category of “a danger to oneself or others.” Is that how I find myself here, on the other side of an extraordinarily thin line between sanity and its absence—one that I can’t exactly remember crossing? I’m not at all convinced I belong here. And yet part of me is read
y to be taken care of under the thoroughly infantilizing conditions of SO. My childlike dependency on Dr. Kohl has found its ultimate expression. I hope I can hold on to the fantasy that he’s taking care of me; turning against him now that I can’t see him or hear his voice would leave me hopelessly detached.
The bed next to mine is briefly occupied. I don’t talk to her or look at her longer than necessary to assess the damage. I’m not mean to her but I’m also not making the mistake of taking care of her if we’re going to occupy the same room for the next … who knows how long? It’s easy to put her at a remove. I couldn’t care less what she thinks of me. She’s her own problem just as I’m mine. The last thing I want to be is her friend, confidante, or sympathizer. Before I’d know it I’d be sitting in for her mother. I’m too porous—whatever mental equilibrium I can achieve is subject to disruption.
She’s a cutter. Blood arouses some people; it might arouse her, the gory immediacy fueling her ritual self-mutilation. As little as I’ve tried cutting, I suspect the delicate yet determined hand required for a really deep cut is beyond my abilities. I’ve never applied enough pressure on my instrument to make the cut really count. The force combined with the sharpness of the instrument produces unpredictable results. I prefer the control of flesh combusting in layers. Temperature squared and multiplied by seconds equals depth: T2 x S = D—or something like that.
My luck interferes: she’s discharged before my anxiety over her company becomes too much. The room now securely mine, admits must be slim. The insurance revolution churns, policies shrinking, mental health care benefits stingier by the month. Empty beds augur the limited stays that will be the norm of the future. I’m in possession of the gold standard of insurance policies: with just the tiniest deductible, I have a $2 million inpatient cap. The hospital verifies the information on admission—all good. I’m the golden goose.
Liberally spent money ensures I remain alive and unharmed. I take to the pablum of solicitude like a doll, even if I’m unnerved by the experience of the ever-open door, the flashlight bobbing around in the dark, the staff eying every movement, my presence on the hall and state of being alive on record every twenty minutes. The scrutiny of SO comforts me before it morphs, turning me feckless, like a footnote to my own breath. I’ve never been so well documented. Now, nurses with clipboards nestled against a range of breasts from meaty to bud-like, pens in hand, record me. Check, present.
CHAPTER 23
Safe with My Sister
The reality of being kenneled takes only a day or two to shuffle right up close.
B-1’s doctors and nurses are supposed to call the patients on the unit a “community.” It’s a tenet of “milieu therapy” intended to foster patients’ interdependence. As far as I’m concerned, the idea that becoming dependent on others on the ward could be beneficial is the obvious front to a snap trap smeared with peanut butter and bacon grease. However much I might belong here—or not—I recognize that attachment is a danger, not a goal.
I miss smoking alone in the dark, the cherry glowing bigger and hotter with each drag, quiet blackness my only other company. But I’m here in a crowd, escaping onto the scratchy brown wool blanket, where I read, hours building into days of pages—Thomas Mann, Jim Harrison, Leo Tolstoy, and Ernest Hemingway. I indulge in the last only when most pitiful, most nostalgic for my childhood. He may have been a misogynist and a drunk but the Nick Adams stories, especially “Big Two-Hearted River,” power-blasts away a ponderous dread, bringing me to where “it was cool in the shade, sitting on a log.” Effortlessly I’m back in time, camping with my sister in a tight clearing, gathering dry sticks, making a fire, grilling a pork chop. We’re somewhere, out beyond the house, having come just far enough to count the night as an adventure, Whitey my dog circling in the fragrant, fatty air. My sister keeps me safe.
The defining characteristic of B-1 is collective boredom. What I see are aimless, unhappy individuals wrapped up in their pathology. The TV’s always on, patients sitting in groups watching daytime shows. I stay away.
Plucking an immaculate white towel from the rack while a massive gray canvas wheeled hamper collects the dirty ones from the previous day and night is my greatest luxury. A pineapple round on a paper plate topped with a scoop of chicken salad, a white bun so airy it can’t possibly be food, a tub of Fleischmann’s margarine, a cute mini-carton of milk, and a tapioca pudding earn the slightest glance. The removal of the offering is accomplished by my placing the tray and its untouched contents on the floor in the hall outside my door. Room service, please.
Waiting out my SO, I eat little and my clothes fit better each day. I couldn’t be happier because I like nothing better than lying on my back seeing my hip bones jut up to serve as tent poles for the elastic on my underwear. I’m not there yet but the sight of my rib cage showing its shape ever so faintly above the divot of my belly button feels better than any kiss, just as thighs not touching at the top where that vicious fat likes to settle redeems my mood for hours. Many girls here are too thin but I’ve never been there so I wouldn’t know what it feels like or even if it exists for me.
My chivalrous father hasn’t deserted Baltimore. He finds me a copy of Mann’s out-of-print novel Joseph and His Brothers. One of the nurses delivers it to me with a note. I imagine him wandering used bookstores, searching the shelves only to find copy upon copy of Death in Venice. Perhaps dreading the finality of leaving the state of Maryland or hopeful Admin might call, asking him to retrieve me, he lingers. The New York Times I request can’t be delivered to the hall, the bound cylinder having a history of disappearing en route to the patient, falling in among bored doctors, nurses, social workers, administrators, and orderlies. As suggested, my father puts a mail subscription in my name instead. It’s not exactly “home delivery” but it communicates a terrible finality.
Before boarding his flight back to California, my father arranges for a weekly delivery of fresh cut flowers. He purchases a tall, tasteful, glass vase. An inspired gardener, he chooses deliberately; a chef with an acute sense of flavor, scent, movement, and color, he doesn’t mildly appreciate beautiful things, they matter to him. Flowers, like food, wine, and books, are among the handful of interests he deems worth pursuit.
Too bad glass in any form, given its propensity for becoming shards, has long been verboten on B-1. He replaces it with a brass goblet decorated with cavorting Greek goddesses, their Dionysian abandon etched into the dark metal. Looking at it, I wonder how consciously my father selected the design—I suspect the joyful scene was meant to be cheering. Serving its improvised purpose, the unbreakable goblet holds fresh water and a sequence of bouquets arriving as steady as the week itself at the same hour each Monday—airy French tulips in the lightest pink, brash gerbera daisies in supersaturated flame tangerine, flawless stock in undiluted white clusters. I’m sorry for their grim life; they’re too good for the place. Their scent, texture, and color suggest the unavailable green growth on display beyond the windows. I imagine eating the blossoms, ingesting the fullness of their beauty, and then spitting back the spent petals, stamens, and pistils.
On Sunday night lightning turns the sky and trees on and off as if a child has been set loose to play with the divine switch. On my now familiar bed in the dark I envy the intermittently visible trees and lawn. The rain slicks the grass as dead leaves form a reflective gloss on the ground. Snail paradise. I tap into the memory of wet, cut grass stuck to bare skin from toe to ankle. The itch I feel atomizes the aspiration to escape, one that refuses rest. If I could only walk and walk until I was lost enough to remain that way.
My sister Nicole and I have always been walkers. We stuck together, by turns suffering and giggling, over the two miles we trekked to the school bus stop at the Ranch in Idaho, the temperature five or even ten degrees below 0°F. It was precisely as far as we had walked in Aspen, but back then the banked snow loomed above us along the road or we sank up to our knees when we took the trail along the irrigation ditch. Late
r in Nepal, without a Sherpa, we hiked the seemingly endless miles of ascents and descents from the village of Jiri to Namche Bazaar at 11,000 feet elevation and from there to Gorak Shep, just a day hike from the lowest of the Everest base camps.
Above all else, we were tough, which left scant space for letting our guard down long enough to realize we wanted anything else. As spoiled as we were by travel, books, and food, we were uncommonly self-reliant.
I was safe with my sister next to me. When she was there nothing terrible could happen. She’s too courageous for that, her soul big and certain of itself. Encased in our greasy, puffy down parkas, layered long underwear, turtlenecks, felt-lined zip-up snowmobile boots, wool hats, mohair scarves, and OshKosh B’gosh overalls, we walked through the black morning under the auroral Idaho starlight. The passage through came on fresh and dangerous every time but we never faltered.
I can hardly speak to her now for shame at my breakdown. I’ve kept to myself so long and now I’ve failed the endurance test we always passed together. My will is spent. All this inside hearing, the noise behind the 11s, blurs my senses. I am deeply, inexcusably weary. I miss those days. I miss what my sister and I were to each other.
CHAPTER 24
Passing Plates
Days three, four, five, six. It’s September 16. I gaze at the cut flowers in their metal goblet. I don’t deserve the flowers but I adore them. I try to be rational while the subterranean river of 11s tugs at reason. The din of movement and voices on the hall wears on my ability to hold a critical perspective. At my worst moments I’m fixated on Dr. Kohl’s betrayal. I’m not sure I have a choice about giving in—or not—to the destructive pull of the 11s. They form a powerful current: get the Buddenbrooks razor and put it to use.
Lights On, Rats Out Page 12